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Out On The Couch

The Courage to Care for the Transitioning Self

Posted: 5-22-23 | Karina Schneidman

How It Begins

Any life transition is hard. The human condition is a complicated one at best. It is riddled with pain, sorrow, confusion, darkness, and the unknown. However, that also comes with the gift of growth, beauty, love, happiness, peace and of course courage to live the life each of us deserves. As these [...]

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5 Tips for Affirmative Therapists During Autism Acceptance Month

Posted: 4-12-23 | The Affirmative Couch

As you may know, April is Autism Acceptance Month. As knowledge of autism continues to grow and change with every year—and there are a greater number of adults who know that they are autistic—we wanted to highlight a few things that can help affirmative therapists work with their autistic clients.

 

Avoid Using Functioning Labels

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3 Trauma-Informed Alternatives to Positive Affirmations

Posted: 3-28-23 | The Affirmative Couch

Whether in therapy, in self-help books, or in broader discourse about mental wellness on social media, there is a lot of discussion about positive affirmations. In general, the idea behind positive affirmations is to “train” the brain to look for opportunity and growth rather than perseverating on failure and stagnation. But are positive affirmations for [...]

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Kink Affirmative Therapy: Perceptions of Power

Posted: 3-14-23 | Tayler Rose, MA

When practicing kink affirmative therapy, it is important as a clinician to understand the inherent dynamics that play into working with clients who are a part of the Bondage and Discipline, Dominance, and Submission, Sadism and Masochism (BDSM) community. Over 40 percent of the United States population has fantasies about or has engaged in BDSM [...]

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Gottman’s Four Horsemen in a Polyamorous Context

Posted: 3-1-23 | Stephanie Sullivan

The Four Horsemen of the Apocalypse is a metaphor originally put forth by Dr. John Gottman, a prevalent relationship researcher. Dr. Gottman used this description for four forms of negative communication patterns (criticism, contempt, defensiveness, and stonewalling) because they will often, and very effectively, end a relationship (Gottman & Silver, 2015). While this research was [...]

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5 Essential Self-Care Tips for Psychotherapists

Posted: 12-14-22 | Andrew Kravig

Being an affirmative psychotherapist is an important job. It’s easy to get caught up in caring for others and overlook your own well-being. While doing psychotherapy may be seen as “selfless,” it should never be “self-sacrificing.” For your sake, and for the sake of your clients, it is crucial to take a step back and [...]

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Managing Conflict in Affirmative Therapy

Posted: 12-7-22 | The Affirmative Couch

Relationships between therapists and clients can involve vulnerability. Exploring topics related to identity is delicate work.  Both client and therapist may be impacted by their education, knowledge, and preconceptions. Moreover, therapy often requires discomfort. None of this is news but: but managing conflict while centering your client’s experiences takes skill and experience.

Affirmative therapy requires [...]

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Supporting LGBTQIA+ Youth to Address Microaggressions

Posted: 11-22-22 | Tayler Rose, MA

Microaggressions are “everyday derogations, slights, and invalidations that are often delivered to people of minority or marginalized backgrounds” (Lui & Quezada, 2019). Daily microaggressions such as heterosexism (thinking heterosexual people are the norm and assuming everyone is heterosexual), assuming gender pronouns, or placing heterosexual norms about sexuality or relationships on an LGBTQIA+ person [...]

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Supporting Your ADHD Clients (and Colleagues)

Posted: 10-19-22 | The Affirmative Couch

October is ADHD Awareness Month—in contemporary media, ADHD is often presented as affecting mostly children, and more specifically  mostly young white boys (and we could do a whole separate blog about how cissexism, misogyny, and racism impact the diagnosis and treatment of ADHD).

ADHD continues into adulthood, and studies show that it [...]

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Substance Use Disorders in LGBTQIA+ Youth

Posted: 9-14-22 | Tayler Rose, MA

*Content warning: eating disorders, substance use disorders in LGBTQIA+ youth

LGBTQIA+ youth are more susceptible to developing a substance use disorder than people not in this group (Garcia et al., 2019). Affirming therapists must be cognizant that LGBTQIA+ clients are more likely to make impulsive decisions and have a high rate of dysphoria around body [...]

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Red & Green Flags of Emotional Safety

 Rainbow flags stand as one of the hallmarks of the LGBT community, symbolizing colorful celebrations of life, nature, sunlight, and spirit, amongst other positive notions (Gilbert Baker Foundation, n.d). However, as we consider emotional safety in queer relationships, it’s imperative that we recognize certain other “flags,” some of which dictate the need for increased boundaries, [...]

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How to make your practice more CNM affirmative

Posted: 8-10-22 | Andrew Kravig

As a young therapist intern, I once had a supervisor ask me what the difference was between “an open relationship and just screwin’ around.” I had to spend almost the full two hours of that group supervision meeting educating my supervisor and fellow interns about the nuances of consensual non-monogamy (CNM). I argued that  an [...]

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Eating Disorders with LGBTQIA+ Youth

Posted: 8-2-22 | Tayler Rose, MA

 *Content warning: eating disorders, sexual assault, aggressive behaviors

The intersection of eating disorders with LGBTQIA+ youth is a challenging presentation to treat. A therapist’s chief concern is that eating disorders have a higher mortality rate than any other mental health disorder (Edakubo & Fushimi, 2020). Secondly, people in the LGBTQIA+ community  have a high rate [...]

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Gender Pronouns: Key Things Therapists Should Know

Posted: 7-20-22 | Andrew Kravig

Gender pronouns are an essential part of understanding how an individual identifies and communicating with them appropriately. As a therapist, using the correct gender pronouns for your clients will elevate your practice by helping them feel both seen and heard. If you don’t identify as trans or gender non-binary (TGNB) yourself, it can be hard [...]

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5 Challenges Facing the LGBTQ+ Community

Posted: 6-29-22 | Andrew Kravig

The fight for LGBTQ+ rights has come a long way, but the battle for acceptance is far from over. Therapists working with clients who are members of the LGBTQ+ community commonly see elevated rates of mental health challenges in this population, including anxiety, depression, trauma, disordered eating, and even suicidal ideation (Young & Fisher-Borne, 2018). Many [...]

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Mental Health Outcomes of Gender-Affirming Care

In recent years, both the ethics and efficacy of affirmative mental healthcare have been debated on a national stage. In 2022 alone, Florida state legislators have proposed a “Don’t Say Gay” bill, Alabama passed a law outlawing gender-affirming medical or mental healthcare for teens, and more than a dozen states like Ohio have followed in [...]

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4 ways affirmative therapists can support transgender teens

Posted: 4-1-22 | Melissa Dellens

Approximately 1.9 million youth across the United States between the ages of 13 and 17 identify as lesbian, gay, bisexual, or transgender (Williams Institute, 2020). Nearly 70 percent of homeless transgender teens are homeless due to family exclusion (Williams Institute, 2020). Even when LGBTQIA+ youth have stable housing and family life, there are unique stressors [...]

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The Trauma Impact of Cancel Culture

Posted: 3-30-22 | Amelia Ortega

 

 Over the last two years of the COVID-19 pandemic, community relationships have shifted  to a location primarily online. The centrality and importance of technology-mediated relationships is now an established interest within the fields of social work and psychology (Trepte et al., 2017, Okdie et al., 2018) along with social and relational conflicts like cancel [...]

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Working With LGBTQIA+ Clients: What Therapists Should Know

Posted: 3-30-22 | Andrew Kravig

As a therapist, your first priority is understanding your clients’ needs. This is no less true when working with LGBTQIA+ clients. Many therapists have distanced relationships with the LGBTQIA+ world.  Some clinicians do not feel the need to explore LGBTQIA+ experience and identity. This lack of exposure threatens to hinder your work with members of [...]

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Deconstructing Compulsory Heterosexuality in Psychotherapy

A key aspect for therapists practicing affirmative psychotherapy is deconstructing heteronormativity. Defined by the American Psychological Association as “the assumption that heterosexuality is the standard for defining normal sexual behavior,” heteronormativity stems from a long-standing, embedded cultural belief that traditional gender roles are unchanging and omnipotent. (2022) Taken a step further, heteronormativity becomes compulsory heterosexuality [...]

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How online self-disclosure benefits LGBTQIA+ therapists with lived experience

Posted: 2-18-22 | Teresa Theophano

Self-Disclosure and Community Building

We know that LGBTQIA+ community members are resourceful and resilient. We also know about startling disparities in the mental health of queer and trans individuals v. that of cisgender and heterosexual ones. As a queer femme clinical social worker who has spoken openly and published about my own lived experience of [...]

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